Acceptance and Commitment Therapy (ACT)
You've tried to think positively. You've tried to distract yourself, push the feeling down or wait until you feel ready. And somehow, the harder you fight the anxiety, the louder it gets.
ACT offers a different way through. Instead of battling your thoughts and feelings, you learn to make room for them, and put your energy into the life you actually want to be living.
What is it?
01Have you ever put your life on hold until you felt less anxious, more confident or more like yourself? Waiting to feel ready before you apply for the job, book the trip or say the honest thing?
Acceptance and Commitment Therapy, or ACT (said like the word "act"), is a talking therapy from the same broad family as CBT. But where CBT often asks whether a thought is true, ACT asks a different question: is holding on to this thought helping you live the way you want to?
Acceptance doesn't mean liking what you feel, giving up or putting up with harm. It means letting difficult feelings be there, without spending all your energy trying to make them disappear. Commitment means taking steps, often small ones, towards what matters to you, with those feelings along for the ride.
The aim isn't to feel good all the time. It's to build what ACT calls psychological flexibility: being able to stay present with whatever you're feeling, and still act in line with what you value.
ACT was developed in the United States by psychologist Steven Hayes and colleagues. Australian doctor and therapist Dr Russ Harris has helped bring it to a wide audience through his book The Happiness Trap.
You don't need to know what your values are before you start. Working them out is part of the work.
What may it help with?
02People often find their way to ACT when the struggle itself has become exhausting.
Why do I keep waiting to feel better before I live my life? Why does the voice in my head always get the final say? Why do I avoid the things I care about most? Why does trying not to feel something only make it bigger?
ACT is commonly explored for anxiety, depression, feeling stuck, ongoing stress and low self-worth. It has also been widely studied for chronic pain and substance use, where learning to sit with discomfort, cravings or pain can change how much they run your life.
It can be especially helpful when life involves something that can't simply be fixed: a long-term illness, grief, pain or a situation outside your control. It doesn't ask you to pretend it's fine. It helps you build a life alongside it.
How does it work?
03ACT starts from a simple observation: pain is part of being human, but the struggle against pain can add a whole extra layer of suffering. Trying not to think about something keeps it front of mind. Avoiding what scares you shrinks your world. ACT helps you put down your end of that tug of war.
It works with six connected processes. You don't have to master them in order. They tend to grow together.
- Acceptance. Making room for uncomfortable feelings instead of fighting them.
- Defusion. Stepping back from your thoughts and seeing them as thoughts, not facts. "I'm useless" becomes "I'm having the thought that I'm useless." Same words, a little more space.
- Being present. Bringing your attention back to what's happening right now, often through mindfulness.
- The observing self. Noticing that there's a part of you that can watch your thoughts and feelings without being swept away by them.
- Values. Getting clear on what truly matters to you, and the kind of person you want to be.
- Committed action. Taking meaningful steps towards those values, even when it's hard.
ACT generally doesn't try to change what your thoughts say. It changes your relationship with them. Your mind may still tell you that you'll embarrass yourself. You can hear it, thank it for trying to protect you, and walk into the room anyway.
Much of this is felt in the body too. A tight chest or a racing heart becomes something to notice and breathe with, rather than a signal that you have to stop.
"The aim of ACT is to help you live a rich, full and meaningful life..."
Dr Russ Harris, The Happiness Trap
What does the evidence say?
04ACT is widely used by psychologists and therapists in Australia, and it has a large and growing body of research behind it.
A 2020 review that brought together 20 earlier reviews found ACT helped across every condition it looked at, including anxiety, depression, substance use and chronic pain. It generally did better than waiting lists, usual care and most other comparisons, and about as well as CBT. [1]
None of this means it suits everyone. Some people love how practical and values-driven it feels. Others want more time with where their patterns came from, or with the body. Both are reasonable.
What does a session or practice look like?
05ACT can be one-on-one, in a group, online, or through guided self-help books and programs.
Sessions often use short exercises and everyday metaphors to help the ideas land in your body, not just your head. A session might include:
- a brief mindfulness or grounding practice
- noticing a difficult thought and practising stepping back from it
- exploring what matters to you in your relationships, work, health and play
- choosing one small, values-based step to take before next time
Some of it can feel a little unusual at first. You might be asked to say a harsh thought in a silly voice, or picture your thoughts as leaves floating down a stream. It sounds odd. It can also be surprisingly freeing.
Finding the right person
ACT training matters. So does how you feel in the room. A good practitioner helps you find your own values, rather than handing you theirs.
Something to try
Next time a harsh thought arrives, try putting "I'm having the thought that..." in front of it. Notice whether anything shifts, even slightly. Then ask yourself: "If this feeling came along with me, what's one small thing I could do today that matters to me?"
Going further
The Happiness Trap by Dr Russ Harris is a practical, popular introduction to ACT. It can be a helpful starting point on its own or alongside therapy.
Risks and considerations
06Acceptance is never about accepting harm. In ACT, acceptance is about what's happening inside you. It never means staying in an unsafe situation or relationship.
Mindfulness can feel uncomfortable at first, especially after trauma. Turning inwards can stir things up. Let your practitioner know, so they can slow down, suggest keeping your eyes open or adapt the exercises.
It can feel less structured than CBT. If you like clear, step-by-step techniques, say so. Many practitioners blend approaches.
Questions to ask a practitioner
07- Are you a registered psychologist? If not, what are your qualifications, and who supports you through supervision?
- What ACT training have you done?
- Why do you think ACT is a good fit for me, and how is it different from CBT?
- How will we work out what matters to me?
- What will I practise between sessions?
- How will we know whether it's helping, and what happens if it isn't?
You’ve read about it. Now what can you actually do?
You don’t need to have the perfect plan. Choose the next step that feels most useful for where you are right now.
Always speak with a qualified health professional before starting something new. If you are struggling right now, find immediate support.
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This is educational information. It is not a recommendation that this approach is right for you. Always speak with a qualified health professional.
